Organization
COSTCO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANGELA LEE PHARM.D. (PHARMACIST)
(773) 988-2479
Entity
Organization
Contact information
Practice address
25901 N RIVERWOODS RD, METTAWA, IL 60045-3403
(847) 235-1302
Mailing address
1224 INVERRARY LN, DEERFIELD, IL 60015-3612
(773) 988-2479
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
051295396
IL
Other
Enumeration date
10/11/2014
Last updated
10/11/2014
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